A fourth toddler was today confirmed as having contracted a potentially fatal strain of the stomach bug E coli in an outbreak in Scotland.
The 22-month-old girl, who is described as being in a serious condition, is being treated for kidney failure at the Royal Hospital for Sick Children in Glasgow, according to NHS officials.
Three two-year-olds, who attended the same nursery as the girl in Dunfermline, Fife, were already undergoing treatment for the same condition at Glasgow's Yorkhill hospital.
Charles Saunders, a public health medicine consultant in Fife, said another two possible cases of the O157 strain of E coli in young children were also being investigated.
He said: "As of 10am this morning, there are now four children confirmed as having kidney failure in the suspected E coli O157 outbreak in children attending Careshare nursery in Lauder, Dunfermline.
"All of these children are in hospital and their conditions have been described as serious. We are also aware of a further two possible cases in young children which are being investigated. These two children are at home. The investigation into the possible cause of the outbreak continues," Dr Saunders said.
It has emerged that the nursery had been criticised by government inspectors in January.
Following a visit in October 2005, the HM Inspectorate of Education found staff at the nursery did not change aprons often enough or use two gloves when changing nappies.
The nursery is based at Lauder college in the Halbeath area of the town. It has been closed while health chiefs investigate the cause of the outbreak.
Two of the sick toddlers were named yesterday as Lorna Balfour and Abigail Young. They are both children of students at the college. The third, a boy, and the 22-month-old girl have not been named.
A spokeswoman for Careshare said earlier there was no evidence to indicate the nursery was the source of the illness.
The incubation period for E coli O157 is usually around one to 14 days. Symptoms can include diarrhoea, nausea, vomiting, stomach pain and fever.
This strain of the stomach bug killed 21 people in Wishaw, Lanarkshire, in 1996 - the world's worst recorded instance of E coli poisoning.
The outbreak, which infected more than 400 people, was traced to John Barr's butcher shop in Wishaw.
